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Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil

Authors
  • Carvalho-Louro, Daniela Mariano1
  • Soares, Eric Bassetti2
  • Trevizoli, Jose Eduardo1
  • Marra, Thayna Moreira Gomes3
  • da Cunha, Alexandre Lima Rodrigues4
  • Rodrigues, Marcelo Palmeira5
  • Carvalho-Furtado, Adriana Claudia Lopes1
  • dos Santos, Beatriz Taynara Araujo6
  • de Assis da Rocha Neves, Francisco3
  • 1 Instituto Hospital de Base, Brasilia, Federal District, 70322-000, Brazil , Brasilia (Brazil)
  • 2 Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, 04711-130, Brazil , Belo Horizonte (Brazil)
  • 3 University of Brasilia, Brasilia, Federal District, 70919-970, Brazil , Brasilia (Brazil)
  • 4 Sabin Laboratory Ltd., Brasilia, Federal District, 70632-300, Brazil , Brasilia (Brazil)
  • 5 University of Brasilia, Brasilia, Federal District, 70673-432, Brazil , Brasilia (Brazil)
  • 6 Secretaria do Estado de Saude do Distrito Federal, Brasilia, Federal District, 70770-200, Brazil , Brasilia (Brazil)
Type
Published Article
Journal
BMC Infectious Diseases
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Feb 10, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12879-020-4809-2
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundIdentifying patients with hepatitis C virus (HCV) infection and enhancing the cascade of care are essential for eliminating HCV infection. This study aimed to estimate the prevalence of positive anti-HCV serology in Brasilia, Brazil, and evaluate the efficiency of the cascade of care for HCV-positive individuals.MethodsThis cross-sectional study analyzed 57,697 rapid screening tests for hepatitis C in individuals aged > 40 years between June 2018 and June 2019. HCV-positive patients were contacted and scheduled to undergo the HCV RNA viral test, genotyping, and transient elastography.ResultsThe prevalence of positive serology was 0.27%. Among 161 patients with positive anti-HCV serology, 124 (77%) were contacted, 109 (67.7%) were tested for HCV RNA viral load, and 69 (42.8%) had positive results. Genotype 1 (75%) was the most prevalent genotype. Among 65 patients (94.2%) who underwent transient elastography, 30 (46.2%) presented with advanced fibrosis. Additionally, of the 161 patients, 55 (34.1%) were referred for treatment, but only 39 (24.2%) complied, with 36 (22.4%) showing sustained virological response. By the end of the study, 16 patients were still awaiting to receive medication.ConclusionsThe prevalence of HCV-positive patients was low in Brasilia, and the gaps in the cascade of care for these patients were significantly below the targets of HCV infection elimination. This study opens new avenues for eliminating HCV infection and suggests that partnerships with clinical laboratories to conduct anti-HCV tests are a useful strategy to improve HCV diagnosis.Trial registrationResearch Ethics Committee of the Faculty of Health Sciences of the University of Brasília - UNB (CAAE number 77818317.2.0000.0030) and by the Ethics Committee of the Health Science Teaching and Research Foundation - FEPECS/SES/DF (CAAE number 77818317.2.3001.5553).

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